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Journal of American Medical Association (JAMA)24th August 2024
India
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New Delhi, August 27, 2024:
The World Health Organization (WHO) today launched a global Strategic Preparedness and Response Plan to stop outbreaks of human-to-human transmission of mpox through coordinated global, regional, and national efforts. This follows the declaration of a public health emergency of international concern by the WHO Director-General on 14 August.
The current plan is subject to inputs by Member States, who were briefed on the plan on Friday, 23 August.
Since the worldwide outbreaks began in 2022, mpox cases have simmered at low levels in multiple countries (Clad II version). Now, the DRC (Democratic Republic of Congo) is seeing hundreds of cases each month caused by a version known as Clade I mpox that has been linked with a higher transmissibility and mortality rate than the previous clade II version.
In mid-August, Sweden reported the first case of clade I mpox outside Africa. on August 14, the World Health Organization (WHO) announced its second public health emergency of international concern due to mpox
The global outbreak that began in 2022 was driven by clade II mpox, a possibly less transmissible and less virulent version than the clade I variants that is now spreading in African countries.
The vast majority of the nearly 100 000 people with laboratory- confirmed mpox cases worldwide, most of which were clade II infections, have been younger men transmitted predominantly by homo sexual contact(86%)
Recently About 52% of people with confirmed mpox in the DRC’s South Kivu in late 2023 and early 2024 were women, nearly a third of whom were sex workers. Children below 15 years are also affected.Estimates place the clade I case fatality rate from about 1% to upward of 10%. which is much higher than previous one (Clad II; 0.1 to 4%).Use of antiviral drug tecovirimat, have found to lower mortality rates
According to Dr. G.C. Khilnani, “Catastrophe of Covid is fresh in our minds hence any threat of outbreak of viral infection gets one worried. Monkeypox virus is from family of small pox virus which killed and disabled large number of people before being eradicated from the world. This virus is largely transmitted by skin to skin and airborne and transmission and by fomites is not so important.
The new strain of this virus (Clad-I ) seems to be more transmissible and has higher mortality. Another development is availability of effective antiviral drug (tecovirimat ) and vaccine (JYNNEOS).
The initial symptoms are those of a flu-like illness with fever, malaise, headache, and fatigue often with swelling of lymph nodes. Rashes appears on hands face and other parts of body. Complications of monkeypox include pneumonia, encephalitis, and eye infections
It is important to be aware of this potentially fatal disease which has no specific symptoms. The dictum of “when you neglect the disease anywhere, it spreads everywhere’ should be followed. In the year 2022 few cases were reported from Kerala. Let us hope that it does not reach India this time as the virus (Clad-I) is reported to be more transmissible and has higher mortality.”
G C Khilnani is the Chairman, PSRI Institute of Pulmonary, Critical care and Sleep Medicine. Formerly, Professor and Head, Dept of Pulmonary, Critical care and Sleep Medicine AIIMS, N Delhi
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